Post Traumatic Stress Disorder [PTSD]

Post-traumatic stress disorder (PTSD) is an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include: violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat.

Military troops who served in Vietnam and the Gulf Wars; rescue workers involved in the aftermath of the Oklahoma City Bombing; survivors of accidents, rape, physical and sexual abuse, as well as other crimes; immigrants fleeing violence in their home countries; survivors of hurricane Katrina; and people who witness traumatic events are among the people who may develop PTSD. Families of victims can also develop the disorder.

Fortunately, through research supported by the National Institute of Mental Health (NIMH) and the Department of Veterans Affairs (VA), effective treatments have been developed to help people with PTSD. Research is also helping scientists better understand the condition and how it affects the brain and the rest of the body.

What Are the Symptoms of PTSD?
Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when symptoms last more than one month.

When Does PTSD First Occur?
PTSD can develop at any age, including childhood. Symptoms typically begin within 3 months of a traumatic event, although occasionally they do not begin until years later. Once PTSD occurs, the severity and duration of the illness varies. Some people recover within 6 months, while others suffer much longer.

What Treatments Are Available for PTSD?
Research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, exposure therapy, and EMDR (eye movement desensitization and reorganization), in which the client is able to reprocess painful memories. Medications that help ease the symptoms of depression and anxiety and help promote sleep are also helpful in treating PTSD. When PTSD is diagnosed, referral to a mental health professional that has had experience treating people with the disorder is recommended. The NNU counseling center is equipped to treat PTSD as well as offer referrals for doctors and mental health professionals.

Do Other Physical or Emotional Illnesses Tend to Accompany PTSD?
Co-occurring depression, alcohol or other substance abuse, or another anxiety disorder are not uncommon. The likelihood of treatment success is increased when these other conditions are appropriately diagnosed and treated as well. Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common. Doctors often treat the symptoms without being aware that they stem from PTSD. NIMH, through its education program, is encouraging primary care providers to ask patients about experiences with violence, recent losses, and traumatic events, especially if symptoms keep recurring. When PTSD is diagnosed, referral to a mental health professional that has had experience treating people with the disorder is recommended.

Who Is Most Likely to Develop PTSD?
People who have been abused as children or who have had other previous traumatic experiences are more likely to develop the disorder. Research is continuing to pinpoint other factors that may lead to PTSD.

What Are Scientists Learning From Research?
Research has shown that PTSD clearly alters a number of fundamental brain mechanisms. Because of this, abnormalities have been detected in brain chemicals that mediate coping behavior, learning, and memory among people with the disorder. Recent brain imaging studies have detected altered metabolism and blood flow as well as anatomical changes in people with PTSD.

The following are also recent research findings:

Some studies show that debriefing people very soon after a catastrophic event may reduce some of the symptoms of PTSD. A study of 12,000 school children who lived through a hurricane in Hawaii found that those who got counseling early on were doing much better two years later than those who did not.

People with PTSD tend to have abnormal levels of key hormones involved in response to stress. Cortisol levels are lower than normal and epinephrine and norepinephrine are higher than normal. Scientists have also found that people with this condition have alterations in the function of the thyroid and in neurotransmitter activity involving serotonin and opiates.

When people are in danger, they produce high levels of natural opiates, which can temporarily mask pain. Scientists have found that people with PTSD continue to produce those higher levels even after the danger has passed; this may lead to the blunted emotions associated with the condition.

It used to be believed that people who tend to dissociate themselves from a trauma were showing a healthy response, but now some researchers suspect that people who experience dissociation may be more prone to PTSD.

Animal studies show that the hippocampus -- a part of the brain critical to emotion-laden memories -- appears to be smaller in cases of PTSD. Brain imaging studies indicate similar findings in humans. Scientists are investigating whether this is related to short-term memory problems. Changes in the hippocampus are thought to be responsible for intrusive memories and flashbacks that occur in people with this disorder.

The content of this fact sheet was adapted from material published by the National Institute of Mental Health.